Follow up Study of Embolized Brain Aneurysms

We describe our experience at the Neuroradiology Service, Bellaria Hospital, Bologna, using three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) with Maximum Intensity Projection reconstructions without gadolinium administration in 50 asymptomatic patients with saccular cerebral aneurysms following microcoil embolization. 3D TOF MRA follow-up was done one, three and six months and one year after treatment. The first MRA was compared with the angiogram obtained immediately after treatment and served as a reference for subsequent MRA monitoring. Angiographic follow-up was only undertaken in some patients, when a flow signal was present in the coil mesh or neck region or in the aneurysmal sac, and in relation to the degree of occlusion obtained by embolization. Eight out of the 50 patients underwent redo embolization after MRA disclosed recanalization confirmed by angiography. 3D TOF MRA was fast, straightforward and very useful in the short and long-term follow-up of patients after embolisation, proving a first choice method with a good correlation between the reference angiogram and MRA findings. 3D TOF MRA was also valid in the diagnosis of clinically significant findings confirmed by angiography in all cases, thereby selecting patients requiring further diagnostic investigation by angiography and possible redo embolization.